The LPN Care Manager/Patient Education Specialist oversees the development of community health promotion and education services which encourage and support healthy living concepts to motivate patients to adopt healthy behaviors and promote self-management of their health and wellness. The LPN Care Manager/Patient Education Specialist also provides education and support to patients with chronic medical conditions, including diabetes, cardiovascular disease, obesity, and other chronic diseases, who access care at the Health and Wellness Centers. In partnership with the patient and medical staff, the LPN Care Manager/Patient Education Specialist develops a care plan that reflects integrated care that is individualized to the patient’s needs, abilities, illness(es). The care plan should also reflect the patient’s social determinants of health and progress towards a commitment to self-management of their illness(es). The LPN Care Manager works to ensure needed access to all physical and emotional services and education/supports on self-management of medical condition(s).
EDUCATION AND EXPERIENCE/QUALIFICATIONS
Nursing degree from an accredited nursing school plus 3 years of progressively responsible experience providing nursing services to full life span populations from diverse economic and cultural backgrounds. Exceptional communication, interpersonal and organizational skills are required. Experience with care management in primary care settings is preferred. Bi-lingual English/Spanish a plus.
Credential(s) Required: Current State of Connecticut Unencumbered Licensed Practical Nurse license.
Wheeler provides equitable access to innovative care that improves health, recovery and growth at all stages of life.
Wheeler Clinic offers access to a comprehensive array of benefits, including:
For Good Health
-Anthem Medical, Prescription, Dental and Vision insurance
-Health Savings Account (HSA), with company contribution of $500 per year
-Free annual flu shots
For a Secure Future
-Company paid Life and AD&D insurance
-Company paid long-term disability insurance
-403(b) Plan, with clinic contributions for eligible employees
-For Career Advancement
-Education Reimbursement Program
-Training and development opportunities
For Work Life Balance
-Generous paid time off, including vacation, sick and personal leave
-Employee Assistance Program (EAP)- Free and confidential counseling
-Employee discounts at local spa and on cell phone services
ESSENTIAL DUTIES AND RESPONSIBILITIES
Provides care management services to patients with complex health care needs who present to the Health/Wellness Center for care.
Develops, in consultation with the patient and the medical staff, a comprehensive, person-centered, self-management plan that includes all physical, emotional, and psychosocial relevant health information.
Provides health education and wellness interventions specific to patients’ chronic condition(s).
Educates patients and/or family members on the importance of preventative and wellness/health-promoting lifestyle interventions, such as immunizations, promotion of health screenings, smoking prevention and cessation, nutritional counseling, obesity reduction and prevention, increasing physical activity, substance use prevention/early intervention and harm reduction and promoting independence and skills development related to disease self-management and self-administration of medications.
Identifies and/or develops education and supportive interventions to increase patients’ skills and confidence in managing their health, including regular assessment of progress and setbacks, goal setting, and problem-solving support.
Plans and participates, in collaboration with Community Outreach Workers, in community health fairs, events, and programs to provide education, and support to manage health outcomes.
Maintain a minimum case load of 100 active clients in varying degrees of support required.
Participate in Quality Improvement Committees as assigned.
Participates in and/or facilitates weekly multidisciplinary team meetings focused on coordinating care within an interdisciplinary team, encouraging team participation in developing actionable plans to support patients’ health and wellness progress.
Engages patients in health and wellness related life skill development and activities.
Participates and provides input for daily multi-disciplinary huddles.
Assists with management of Medication Assisted Treatment clients care coordination.
Engages clients in clinic based chronic care nurse visits aimed at improving health outcomes and quality measures.
Perform physical assessments and CLIA waived point of care testing per standing orders and nursing protocols pertinent to the visit being rendered.
Must be able to pass a respirator fit test at time of hire and on an annual basis.
Performs job responsibilities consistent with standards for best practice nursing, including excellent communication with all providers to ensure the delivery of high quality care.
Follow-up with external care providers when barriers to care are identified.